Abstract :Abstract
Prior to the groundbreaking studies of a few pharmacologists, the treatment of hypertension had
loomed a formidable obstacle to physicians. The discovery of new directions in anti-hypertensive
therapy created a paradigm for drug action at specific cellular sites. This review recounts the early
work that led to the successful treatment of this common malady. Hexamethonium represented a
milestone in the treatment of hypertension when it was developed by William Paton and Eleanor
Zaimis. James Black, in his discovery of propranolol, made one of the most important contributions
to clinical medicine and pharmacology in the twentieth century. Albrecht Fleckenstein’s finding
that calcium antagonist’s block excitation-contraction coupling represented another major advance
in the pharmacotherapy of anti-hypertensive agents. The common strategy speaks to achieving
selectivity of drug action by applying basic physiological and pharmacological principles to the
actions of various compounds on specific sites or receptors. The implications of these diverse
discoveries were far reaching, spurred new directions in anti-hypertensive therapy, and created a
paradigm for drug action at specific cellular sites. The work underscores the remarkable advances
made in treating hypertension and other cardiovascular diseases when key factors in regulating
blood pressure were recognized and exploited.